U.S. Department of Justice National Drug Intelligence Center July 2011 Situation Report Product Number 2011-S0787-004 Synthetic Cathinones (Bath Salts): An Emerging Domestic Threat Cox Broadcasting. Cox Broadcasting. Executive Summary The National Drug Intelligence Center (NDIC) assesses with high confidence that the distribu- tion and abuse of synthetic cathinones will increase in the United States in the near term, pos- ing yet another challenge to U.S. law enforcement officials. Poison control centers and medical professionals around the country are increasingly reporting patients suffering adverse physical effects associated with abuse of these drugs, further compounding the problem. Available data and law enforcement reporting suggest increasing levels of synthetic cathinone availability and abuse, but such information is limited and precise levels are unknown. U.S. Cus- toms and Border Protection (CBP) currently tracks seizures of synthetic cathinones at U.S. ports of entry (POEs), but many synthetic cathinone products are disguised or mislabeled to impede detection. Because common field test kits, drug-detecting canines, and routine urine drug screens do not detect synthetic cathinones, law enforcement officials are challenged in interdicting such drugs and prosecuting their manufacturers and distributors. Synthetic Cathinones (Bath Salts): An Emerging Domestic Threat Synthetic cathinones, typically marketed as “bath salts” and “plant food,” are sold legally un- der various names (Ivory Wave, Blizzard, etc.) in most areas of the United States. The products are generally sold in retail establishments such as adult stores, independently owned convenience stores, gas stations, head shops, and skateboard shops. The products, as well as their raw chemi- cal components, are also sold on many Internet sites, including popular Internet auction sites. Ad- ditionally, synthetic cathinones have been sold by independent dealers as ecstasya—in powdered form, in single-component tablets and capsules, and in tablets and capsules containing cathinones combined with MDMA (3,4-methylenedioxymethamphetamine) or other illicit controlled sub- stances. Abusers typically ingest, inhale, inject, smoke, or snort (insufflate) the drugs to experi- ence stimulant effects similar to those induced by amphetamine. Manufacturers and distributors of synthetic cathinone products evade U.S. Drug Enforce- ment Administration (DEA) regulation and enforcement because synthetic cathinones are not scheduled under the Federal Controlled Substances Act (CSA). However, possession and dis- tribution of the synthetic cathinones may be prosecuted, albeit with greater difficulty, under the Federal Controlled Substance Analogue Enforcement Act of 1986 (as amended)b of the CSA. The availability and suitability of a prosecution under the analogue statute depends on the particular compound being trafficked and the facts of the case. Further, distributors deceptively market synthetic cathinone products as “not for human consumption” to evade U.S. Food and Drug Administration (FDA) scrutiny. Cathinone products that are introduced into interstate commerce and promoted as alternatives to illicit street drugs may be prosecutable under the Federal Food, Drug, and Cosmetic Act as unapproved new drugs and misbranded drugs. (See the offenses at 21 U.S.C. 331(a), (d) and penalties at 21 U.S.C. 333.)1 Additionally, members of the Congress have introduced legislation to nationally ban the sale of certain synthetic cathinones,c and, as of April 2011, all 50 states and the District of Columbia have introduced or announced plans to introduce legislation banning or restricting the distribution and posses- sion of certain synthetic cathinones and cathinone derivatives. As synthetic cathinones become more regulated, abusers will likely use the Internet with greater frequency to purchase cathi- none products, the raw chemicals used in their production, and products that contain cathi- nones not specifically prohibited by enacted legislation. a. Ecstasy tablets typically contain MDMA (3,4-methylenedioxymethamphetamine) but can contain various other drugs in place of or in combination with MDMA. Other drugs commonly identified in ecstasy include metham- phetamine, amphetamine, BZP (N-benzylpiperazine), and caffeine. b. The Federal Controlled Substance Analogue Enforcement Act, enacted in 1986 as Pub. L. 99-570, title I, subtitle E, provides: “[a] controlled substance analogue shall, to the extent intended for human consumption, be treated . as a controlled substance in Schedule I.” The term “controlled substance analogue” is defined as a substance: (i) the chemical structure of which is substantially similar to the chemical structure of a controlled substance in schedule I or II; (ii) which has a stimulant, depressant, or hallucinogenic effect on the central nervous system that is substantially similar to or greater than the stimulant, depressant, or hallucinogenic effect on the central nervous system of a controlled substance in schedule I or II; or (iii) with respect to a particular person, which such person represents or intends to have a stimulant, depressant, or hallucinogenic effect on the central nervous system that is substantially similar to or greater than the stimulant, depressant, or hallucinogenic effect on the central nervous system of a controlled substance in schedule I or II.” c. S. 409, the “Combating Dangerous Synthetic Stimulants Act of 2011”. 2 Product Number 2011-S0787-004 National Drug Intelligence Center Background Synthetic cathinones are central nervous system stimulants. They are chemically similar to cathinone, a Schedule I controlled substance that occurs naturally in the khat2 plant (Catha edulis). The category of synthetic cathinones includes a number of drugs, such as MDPV (3,4-methylenedioxypyrovalerone) and mephedrone (which have been identified by the FDA Office of Criminal Investigations in illicit “bath salt” products;3 see Appendix A) as well as N-methylcathinone (also known as methcathinone or cat),4 4-fluoromethcathinone (also known as flephedrone or 4-FMC),5 and 3,4-methylenedioxy-N-methylcathinone (also known as methylone, MDMC, bk-MDMA, or M1).6 NDIC uses the term synthetic cathinone products to refer to synthetic cathinones packaged as authentic commercial products. These products include purported beauty and household goods such as “bath salt” products sold as Bliss, Blizzard, Blue Silk, Charge+, Hurricane Charlie, Ivory Snow, Ivory Wave, Ocean Burst, Pure Ivory, Purple Wave, Red Dove, Snow Leopard, Star Dust, Vanilla Sky, White Dove, White Knight, White Rush, and White Lighten- ing.7 Synthetic cathinone products are also marketed as plant food/fertilizer, insect repellant, pond cleaner, and vacuum fresheners.8 Synthetic cathinones are commonly distributed in powder, crystal, and liquid forms, but they are also available and abused in tablet and capsule forms.9 Some synthetic cathinone tablets and capsules have been marketed by distributers as ecstasy—forensic laboratories analyzing seized ecstasy tablets have reported that some tablets contain synthetic cathinones, alone or in combination with other drugs.10 However, these tablets and capsules have not been marketed in retail outlets or on the Internet in conjunction with the more widely recognized “bath salts.”11 Abusers typically ingest, inhale, inject, smoke, or snort (insufflate) synthetic cathinone prod- ucts to experience effects similar to those of amphetamine abuse. Some abusers dissolve the drugs in water or other solvents and proceed to atomizei and inhale them, while others apply the solutions to their mucus membranes by placing drops in their eyes or spraying the solutions in their noses.12 The term synthetic cathinone products, as used in this report, is not meant to refer to legal pharmaceuticals. The prescription drugs bupropion (Zyban®, Wellbutrin®), diethylpropion (Tenuate®), and pyrovalerone (Centroton®) are legal synthetic cathinone products—diethyl- propion is a Schedule IV controlled substance, and pyrovalerone is a Schedule V controlled substance under the Federal CSA. i. Atomizers are devices that use heat, pressure, or vibration to convert a liquid into a vapor or an aerosol mist so it can be inhaled and absorbed through the lungs. Electronic cigarettes are a common type of atomizer that uses heat. Nebulizers—often used by individuals with respiratory disorders and diseases—use vibration or pressure. 3 Synthetic Cathinones (Bath Salts): An Emerging Domestic Threat Synthetic Cathinone Availability and Abuse NDIC assesses with high confidence that the availability of synthetic cathinone products in the United States is high. State and local law enforcement information indicates that synthetic cathinone products are readily available in retail establishments and over the Internet, and some local inde- pendent dealers sell the products. Synthetic cathinone products, most marketed as “bath salts,” are distributed across the country in small, independently owned retail establishments such as adult stores, independently owned convenience stores, gas stations, head shops, and skateboard shops.13 The products, as well as their raw chemical components, are also sold on many Inter- net sites, including popular Internet auction sites and global marketing sites.14 The products are typically “branded” under the names previously listed. Some local independent drug dealers also distribute the products directly to users.15 Available seizure information indicates that significant